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H54.0X3 ICD-10-CM Code: Blindness right eye, category 3

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FY 2026 Apr update / Diseases of the eye and adnexa (H00-H59) / Visual disturbances and blindness (H53-H54)

H54.0X3

Header CodeICD-10-CMOfficial ICD-10-CMCodebook guidance

Blindness right eye, category 3

Blindness right eye, category 3

CMS-HCC V28

0

0

RAF 0

CMS-HCC V24

0

0

RAF 0

ACA/HHS

0

0

RAF 0

ESRD/PACE

0

0

RAF 0

RXHCC

0

0

RAF 0

Code Trumping

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Code Book Path

Official
H54.0Blindness, both eyes
H54.0XBlindness, both eyes, different category levels
H54.0X3Blindness right eye, category 3

Inclusion Terms

Official

ICD-10-CM does not list inclusion terms for H54.0X3 in this effective period.

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for H54.0X3 in this effective period.

Related Child Codes

Official
H54.0X33Blindness right eye category 3, blindness left eye category 3
H54.0X34Blindness right eye category 3, blindness left eye category 4
H54.0X35Blindness right eye category 3, blindness left eye category 5

Includes

Official

ICD-10-CM does not list Includes notes for H54.0X3 in this effective period.

Excludes 1

Official

ICD-10-CM does not list Excludes 1 notes for H54.0X3 in this effective period.

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for H54.0X3 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for H54.0X3 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for H54.0X3 in this effective period.

Last updated: FY2026 ICD-10-CM Apr update, Apr 1, 2026 through Sep 30, 2026. CMS-HCC V28 is 100% phased in for payment year 2026.

What This Code Means

H54.0X3 is the ICD-10-CM diagnosis code for blindness right eye, category 3. H54.0X3 sits in the ICD-10-CM chapter for diseases of the eye and adnexa (h00-h59), within the section covering visual disturbances and blindness (h53-h54).

Header codes like H54.0X3 cannot be reported on claims directly, they organize child codes that share clinical context but the actual diagnosis must be coded to the highest level of specificity supported by the documentation. Coders should look at H54.0X3's child codes and select the one that matches the patient's documented presentation, since payers reject header codes submitted as the primary diagnosis. For risk adjustment workflows, header codes never contribute to a Medicare Advantage member's RAF score on their own; only billable child codes that happen to map to a payment HCC affect risk-adjusted plan payments.

HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for H54.0X3 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Child Codes

Code Hierarchy

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